An unprecedented measles immunization campaign in oPt

BETHLEHEM, 22 November 2004 – Fatima Ibrahim walks gingerly towards a Ministry of Health clinic clutching the hand of her daughter, 2-year-old IkranHamed. Moments later, the child had received a drop of Vitamin A and an injection of measles vaccine – the first among more than half-a-million Palestinian children to receive the treatment.

“I heard about this a while ago by word of mouth. I think it’s useful for my children to get vaccinated,” said the 24-year-old mother. In the background over a portable megaphone, the crackling voice of a Ministry of Health worker droned over the barren hills of Wadra Rahhal, about 20 minutes drive from the West Bank town of Bethlehem.

Ibrahim concedes there are some fears among mothers in the village that vaccinations could cause illness among children but she said it wasn’t enough to scare her away from the vaccination campaign. “This keeps the kids safe.”

The visit to the clinic was part of a national immunization campaign in the West Bank and Gaza against measles and Vitamin A deficiency. It marks the first time that a public health campaign of this scope is implemented in the Palestinian Territory.

The campaign will benefit more than 540,000 Palestinian children living in the West Bank and Gaza, aged 9-59 months old.

On Monday, June 28 – the first day of the campaign – even hard to access areas were reporting widespread coverage. By 11am, almost 500 children were immunized in the southern Gaza Strip city of Rafah alone.

In the town of Thabrah in Wadra Rahhal, dozens of parents showed up to nudge their nervous kids towards health workers. They traveled on foot, by donkey, horses and some by car. Local residents carried plastic chairs and wooden tables into the clinic to create a makeshift immunization site.

Under a cloudless sky in the Gaza Strip Monday, UNICEF Goodwill Ambassador Vanessa Redgrave opened the campaign, while the Deputy Minister of Health Dr Annan Masri cut the ribbon at an afternoon ceremony in the West Bank city of Ramallah. “All the logistics have been made to ensure the success of this campaign. No fees will be collected at all from families,” said Masri.

Over the next three weeks or so, the campaign will cover all 15 districts in the West Bank and Gaza Strip, including hard-to-access areas such as Bedouin communities and closed security zones. (The campaign is being led by the Palestinian Ministry of Health, United Nations Relief and Work Agency (UNRWA) and UNICEF, with the financial support from the Japanese Government and USAID).

While most of the immunization will take place at fixed immunization sites operated by the Ministry of Health and UNWRA, mobile teams will also be deployed to difficult-to-access areas and security closed areas. Donna Carter, UNICEF’s Zonal Officer in Hebron, said a larger 4x4 has been procured for the next three weeks so that health workers could even do some of the jabs from the inside of the vehicle.

The campaign will be publicized through TV, print and radio ads – as well as through special announcements at mosques and other community centers where people gather.

In order to ensure uninterrupted access for the vaccines, special coordination has been made with the Israeli military and officials on both sides. For the campaign to succeed, free and safe passage of vaccines is crucial. If they are delayed or opened, the actual efficacy of the vaccine will be minimized and could result in the decreased immunity of children.

A recent serological survey in OPT found around one-third of young children do not have the required antibodies against the measles virus. In some areas this percentage is even higher, up to 50 percent – exposing the children to the risk of a measles outbreak. Emerging evidence suggests that among the potential causes is that the vaccines used in the routine immunization services in the last two years vaccines might have been compromised.

Measles is caused by a highly infectious virus, and is a leading cause of child mortality globally – infecting 30 to 40 million children each year and killing over 750,000. Many that survive are left with life-long disabilities: blindness, deafness or brain damage. The threat to life is compounded when children are malnourished and even more so in densely populated areas, as is common within the Palestinian community.